130 Professor Thomas B. Fraser [March 20, 



absorption of the venom into the blood-vessels, from the place into 

 which it has been injected by the poison-fangs, by separating this 

 place from the more central parts of the body by a tight ligature. 

 The efficiency of this measure, preventive rather than curative, is 

 fortunately aided by the circumstance that snake-bites are most 

 usually inflicted at parts to which a ligature can conveniently be 

 applied ; for in fifty-four cases collected by Wall, the part in nearly 

 89 per cent, of the cases was on the arras or legs. The ligature 

 having been applied, whenever it is possible to do so, the next 

 measure to adopt is to open up with a knife, to a considerable depth, 

 the minute though deep punctures made by the fangs, and then to 

 apply suction to the wound. Justification is found for this procedure 

 in the fact, demonstrated by experiment, that notwithstanding the 

 rapidity with which venom may be absorbed, a portion of it still 

 remains for a considerable time in the tissues immediately sur- 

 rounding the wound. This has been clearly demonstrated by both 

 Kaufmann and Wall. The suction may be produced by the mouth, 

 and in the absence of more effective apparatus this ready method 

 would be serviceable, while it is attended with danger to the 

 operator only in the infrequent occurrence of fissures or abrasions 

 of the mouth. It is, however, more effectively and without any 

 risk accomplished by a suction pump, such as the most useful 

 pump invented by Mr. Andrew Smith, of Cape Colony, which I now 

 show. 



These steps having been taken, antivenene should be injected 

 into the tissues at and near the wound and, also, under the skin 

 above the ligature ; and the ligature should not be removed until at 

 least half an hour after a sufficient quantity of antivenene has been 

 injected under the skin above it. 



But the important question has yet to be answered, What is a 

 sufficient quantity ? The whole tenor of my remarks to-night has 

 been to show how necessary it is to bear in mind that there is a 

 definite relationship between the dose of venom received and the 

 dose of antivenene required to antagonise it, and that this relation- 

 ship also varies with the conditions of the administration of the 

 antivenene, and, especially, with the interval of time that elapses 

 between the reception of the venom and the administration of the 

 antivenene. 



In snake-bite in man it is impossible to estimate the dose of 

 venom which has been injected, for the nature of the symptoms in 

 the patient cannot give the information even approximately. In 

 searching for a solution of this problem, several facts may be taken 

 into consideration from which assistance may be obtained. And, 

 firstly, what is the probable quantity of venom that a serpent injects 

 into a wound ? Some data for answering this question have, very 

 kindly, been obtained for me by Brigade-Surgeon Lieut.-Colonel 

 Cunningham, of Calcutta. Taking nine adult cobras, healthy and 

 vigorous, he collected from each the venom ejected at a single bite, 



